Foxp3+Treg、Tim-3和CTLA-4水平与T1DM患者病情发生发展的关系  

Relationship between the levels of Foxp3+Treg,Tim-3,CTLA-4 and the pathogenesis of T1DM patients

作　　者：王智峰[1] 李秋梅[1] 姜啸 徐心悦[1] WANG Zhifeng;LI Qiumei;JIANG Xiao;XU Xinyue(Department of Endocrinology,Xinhua Hospital Affiliated to Dalian University,Dalian,Liaoning 116021,China)

机构地区：[1]大连大学附属新华医院内分泌科,辽宁大连116021

出　　处：《国际检验医学杂志》2020年第24期3028-3030,3036,共4页International Journal of Laboratory Medicine

摘　　要：目的分析Foxp3+调节性T淋巴细胞(Treg)、T淋巴细胞免疫球蛋白黏蛋白分子3(Tim-3)和细胞毒性T淋巴细胞相关抗原4(CTLA-4)水平与1型糖尿病(T1DM)患者病情发生、发展的关系。方法选取该院2017年1月至2019年7月收治的80例T1DM患者作为观察组,80例健康者作为对照组;检测外周血中Foxp3+Treg、Tim-3和CTLA-4水平;各指标与T1DM的相关性采用Pearson相关,以分组结果作为“金标准”,应用受试者工作特征曲线分析各指标单独及联合检测对T1DM的预测作用。结果观察组外周血中Foxp3+Treg水平明显低于对照组,Tim-3和CTLA-4水平均明显高于对照组,且差异有统计学意义(P<0.05);T1DM患者外周血中Tim-3和CTLA-4水平与其病情严重程度呈正相关(r=0.518、0.502,P<0.05);而Foxp3+Treg水平与其病情严重程度呈负相关(r=-0.483,P<0.05)。采用Foxp3+Treg、Tim-3和CTLA-4联合检测鉴别T1DM的灵敏度、特异度及曲线下面积分别为93.75%,92.50%和0.957,均明显高于各指标单独检测,且差异有统计学意义(P<0.05)。结论Foxp3+Treg、Tim-3和CTLA-4水平与T1DM病情呈正相关,且各指标联合检测可显著提高鉴别诊断T1DM的效能。Objective To analyze the relationship between the levels of Foxp3+Treg,Tim-3 and CTLA-4 and the occurrence and development of T1DM patients.Methods A total of 80 patients with T1DM treated in the hospital from January 2017 to July 2019 were selected as the observation group and 80 healthy persons were used as the control group.The levels of Foxp3+Treg,Tim-3 and CTLA-4 in peripheral blood were measured,Pearson correlation analysis was used to analyze the relationship between each index and T1DM.Receiver operating characteristic curve was used to analyze the predictive effect of each index individually and jointly on T1DM.Results The level of Foxp3+Treg in the blood of the observation group was significantly lower than that of the control group,and the levels of Tim-3 and CTLA-4 were significantly higher than those of the control group,and the differences were statistically significant(P<0.05).The levels of Tim-3 and CTLA-4 in peripheral blood of T1DM patients were positively correlated with the severity of the disease(r=0.518,0.502,P<0.05),while the level of Foxp3+Treg was negatively correlated with the severity of the disease(r=-0.483,P<0.05).The sensitivity,specificity,and AUC(93.75%,92.50%,and 0.957)of Foxp3+Treg,Tim-3,and CTLA-4 in identifying T1DM were significantly higher than those applied alone,and the differences were statistically significant(P<0.05).Conclusion Foxp3+Treg,Tim-3 and CTLA-4 levels were positively correlated with T1DM disease,and the combined application of various indicators could significantly increase the value of differential diagnosis of T1DM.

关 键 词：Foxp3+调节性T淋巴细胞 T淋巴细胞免疫球蛋白黏蛋白分子3 细胞毒性T淋巴细胞相关抗原4 1型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]